Effect of sacroiliac manipulation on postural sway in quiet standing: a randomized controlled trial

Background

Sacroiliac joint manipulation can alter joint and muscle control mechanisms through local and remote effects. Postural balance is controlled by supraspinal (rambling) and spinal–peripheral (trembling) mechanisms. A manipulation may interfere with postural control in quiet standing.

Cell-based and direct gene transfer-induced angiogenesis via a secreted chimeric fibroblast growth factor-1 (sp-FGF-1) in the chick chorioallantoic membrane (CAM)

Fibroblast growth factor-1 (FGF-1) is a potent angiogenic factor; its structure lacks a signal peptide for secretion. We previously reported that the overexpression of a secreted version of FGF-1 (sp-FGF-1) in microvascular endothelial cells (ECs) enhances cell migration [Partridge et al. J Cell Biochem 2000; 78(3): 487]. In the current study, we have examined the angiogenic effects of sp-FGF-1 in chicken chorioallantoic membranes (CAMs). Two methods of examining the effects of sp-FGF-1 in CAMs were used: cell-mediated transfection via bovine ECs and direct gene transfection. In the cell-mediated gene transfection, those eggs that were implanted with a gelatin sponge seeded with ECs stably transfected to over-express sp-FGF-1 protein showed a significant increase in angiogenesis inside the sponge when compared to eggs treated with vector control-transfected ECs. In the direct gene transfer, eggs received sp-FGF-1 showed a significant increase in vascularization when compared to eggs received vector alone plasmids. These CAM models are useful both for studying molecular mechanisms of angiogenesis and for developing better gene therapy strategies.     

Disseminated intraspinal hydatid disease

Spinal echinococcosis is a rare entity, accounting for 1% of all cases of hydatid disease. The authors report the case of a 60-year-old man whom they treated for recurrent nerve root compression due to disseminated intraspinal echinococcosis (hydatid disease). Six years previously he had undergone surgery on an emergency basis at another institution after presenting with acute paraplegia due to a primary extradural hydatid cyst of the thoracic spine. Unfortunately, during surgical removal of the cysts, the echinococcosis disseminated into the spinal canal. This complication was documented by magnetic resonance (MR) imaging. In the 4 years before the authors treated him, he was hospitalized 4 times for 4 recurrences of nerve root compression. The authors treated the disseminated disease successfully with total T7-8 corpectomy, grafting with titanium cage and Texas Scottish Rite Hospital instrumentation, and long-term administration of albendazole (400 mg daily). Early diagnosis, proper utilization of MR imaging, and radical resection of diseased vertebrae and soft tissues followed by anthelmintic treatment are essential to control disseminated spinal hydatidosis and prevent recurrence.     

Molecular typing of Epidermophyton floccosum isolated from patients with dermatophytosis by RAPD-PCR

We evaluated the ability of randomly amplified polymorphic DNA (RAPD) to type Epidermophyton floccosum isolates recovered from patients with dermatophytosis originating from different regions of Iran. A total of 13 clinical isolates of E. floccosum obtained from Iranian patients were analyzed by RAPD with 7 arbitrary primers (OPN16, OPD18' OPU15, OPX19, R28, OPA04 and OPAA17). Among the applied primers, OPN16 produced banding patterns from all the isolates. In addition, some of the isolates had very close relation. The phenon line which represented the mean similarities was at the value of 73%. At this level, 4 groups were characterized. Two isolates of a patient had different molecular patterns, suggesting infection transmission from different sources in the case of a single patient. RAPD-PCR provided a rapid and practical tool for identification of E. floccosum isolates, which was independent of morphological characteristics, and enhanced laboratory diagnosis of dermatophytosis.     

Bilateral reduction mammoplasty following breast cancer: A case-control study

PURPOSE:

Many women undergo a bilateral reduction mammoplasty after lumpectomy and radiation for breast cancer due to breast hypertrophy. The outcomes of these patients, focusing on complications and the need for additional surgery, are reviewed.

METHODS:

A matched case-control study with patients serving as their own control (treated breast cancer breasts were ‘cases’, healthy breasts were ‘controls’) was performed. Patients were identified through hospital records between 1980 and 2007. Patients treated by lumpectomy and radiation with subsequent bilateral reduction surgery were included. Data regarding demographics, medical history, and peri- and postoperative complications were collected. Measured outcomes included hematoma or seroma, delayed wound healing, infection, nipple-areolar complex problems, scarring, asymmetry and the need for further surgery. Continuous variables are reported as mean ± SD, and categorical variables are reported as proportions.

RESULTS:

Of the nine patients included in the study, delayed wound healing occurred in 22% of cases. Wound infections occurred in 66.7% of cases, with 22.2% experiencing a second wound infection. One patient experienced partial nipple-areolar complex loss on the radiated breast. There was abnormal scarring in 33.3% of radiated breasts. Postoperative asymmetry occurred in 77.8% of patients. Additional surgery was performed on three patients (33.3%).

CONCLUSIONS:

Results of the present study suggest that women with a history of breast cancer treated by lumpectomy and radiation experience higher occurrence of postoperative complications on the radiated breast following bilateral breast reduction. Patients must be informed of these potential risks and require careful postoperative follow-up. An appropriately powered, prospective, multicentred study is required to draw definitive conclusions.     

Femoroacetabular impingement in elite ice hockey players

Purpose

The purpose of this study is to evaluate the presence of clinical and radiological femoroacetabular impingement (FAI) in elite ice hockey players and compare it to a control group of non-athletes.

Methods

Forty participants (20 non-athletes and 20 elite ice hockey athletes) underwent an evaluation of their hip joint, including assessment of range of motion and special provocative impingement tests. Two musculoskeletal radiologists assessed MRIs completed on each participant for radiological findings associated with FAI, including alpha angle, acetabular version angle, acetabular depth, and/or a lateral centre edge angle, and findings of labral and cartilage degeneration. A comparative analysis of the clinical and radiological findings was subsequently completed.

Results

There was a significant difference in the radiological CAM impingement measured by mean alpha angle between both groups (non-athletes: 43.2 degrees, SD 9.7; and athletes: 54.2 degrees, SD 12 (p = 0.003)). There were no statistically significant differences between the groups upon evaluating PINCER impingement. There were no statistically significant differences in clinical examination findings between both groups.

Conclusion

MRI evidence suggests that CAM impingement is more common in the elite ice hockey athlete in comparison with non-athletes. However, as this is a pilot study examining findings in asymptomatic individuals, there is a need for a longitudinal prospective cohort study. In keeping with this, sufficient, long-term follow-up is required to assess at what point, if any, these subjects with radiological findings become symptomatic.

Level of evidence

Cross-sectional cohort study, Level III.     

Fibroblast growth factors, fibroblast growth factor receptors, diseases, and drugs

Maintenance of endothelial cells (ECs), the building blocks of the vascular tree, is a presumed function of fibroblast growth factors (FGFs). In particular, the two prototypic members of FGF family, namely FGF1 and FGF2, due to their potent mitogenic and pro-migratory activities, have the ability to induce metabolic and phenotypic changes in ECs that are required to stimulate angiogenesis. In addition to FGF1 and FGF2, 23 other members of the FGF family have since been identified and characterized and they are reviewed in relation to their disease pathology. Particular emphasis is given to the biology of the FGFs and FGFRs on how they mediate the onset of angiogenesis. The focus of the present review is to survey what is known about the role of the currently identified FGFs and their four high affinity tyrosine kinase receptors in diseases and the angiogenesis-targeted drugs currently in clinical trials. Some new and promising patented drugs that target the angiogenic pathway are discussed. Examination of the currently patented drugs may identify more potent and specific regulators of FGF/FGFR signaling system for treatment of tumor angiogenesis in clinical settings. Additionally, novel drug development strategies are highlighted and reviewed.